“Did he have any systemic symptoms?”, I inquired.
“He endorsed diarrhea”, my resident replied.
“You mean he liked it? Personally, I can endorse a good BM, but not diarrhea.”
“No, I meant he had diarrhea!”
“So why didn’t you just say that?”
In recent weeks, from rotating residents in different specialties, I have heard many symptoms “endorsed” ranging from joint pain, to shortness of breath, to irregular menses. I am sure the patients experienced these, but I am skeptical that they endorsed them.
I thought this might be just an institutional quirk, but I was wrong.
In an excellent case presentation of erythropoietic protoporhphyria (EPP), I read the following: “On review of systems, he endorsed photosensitivity during childhood only.” (1) I doubt that photosensitivity made him a happy child.
According to the Merriam-Webster dictionary, “endorse” is a transitive verb meaning “to approve openly or recommend” (or also “inscribe” as in endorsing a check).
Interestingly, in the same issue there is a letter critiquing the use of cimetidine for EPP (see the post from November 16, 2016 “Cimetidine offers a ray of sunshine for patients with erythropoietic protoporphyria”). Clearly, the authors do not endorse its use, but they endorse the development of a pediatric dose-form of afamelanotide (2). The authors of the index article endorse more rigorous clinical trials to examine the safety, efficacy, and optimal dosing of cimetidine in EPP (3).
I don’t know how this trend started but I hope it comes to a quick end. Bernie can endorse Hillary, Rihanna can endorse Nivea, but patients should not endorse their symptoms! We should endorse accurate histories in an effort to improve patient care.
- Sluzevich JC, Hoesly PM. Pruritic waxy and verrucous papules in a middle-aged man. JAMA Dermatology 2017; 153: 221-2.
- Langendonk JG, Paul Wilson JH. Insufficient evidence of cimetidine benefit in protoporhyria. JAMA Dermatology 2017; 153: 237
- Teng JC, Tu JH. In reply. JAMA Dermatology 2017; 153; 238.